Predicting antenatal care to improve pregnancy outcomes

Socioeconomic factors, such as education and location, can affect access to life-saving antenatal care services. Researchers at Boston Children’s Hospital are taking steps to implement strategies that improve access to prenatal care: by estimating the number of pregnant people who attend the recommended number of visits and identifying pregnant women who are at high risk of do not attend. This could help policymakers allocate resources to populations that do not receive enough prenatal care and could, in turn, improve health outcomes for mothers and babies.

Led by Grace Chan, MD, PhD, an attending physician in the Intermediate Care Program at Boston Children’s, the team analyzed data from rural Amhara, Ethiopia, and built the first predictive models to access to antenatal care services in a low-resource setting. . The results were recently published in PLOS Global Public Health And Open JAMA Network.

Antenatal care improves birth outcomes and prevents maternal and newborn deaths. The World Health Organization (WHO) recommends eight antenatal care contacts during pregnancy to prevent and treat complications, thereby reducing the risk of adverse outcomes such as stillbirth. “High-quality antenatal care is an essential intervention associated with positive birth outcomes. It is important to find women who do not have access to care to target resources and improve their access,” explains Dr Chan.

Researchers collected demographic and health data in 16 rural villages through an existing community-based monitoring program. Study team members enrolled mothers in their study when they were identified as pregnant at health facilities or during community visits and followed them until delivery.

The team found that only 28.8% of women attended four or more antenatal care visits, and no women attended the recommended eight visits.

The predictive models they built incorporated data on the pregnant women’s education, sources of income, diet, and history of previous pregnancies. The researchers found that the models could predict the likelihood of a pregnant person not starting prenatal care with modest performance, using information on the predictors available at three different times during pregnancy.

The team found that factors such as use of contraceptives, consumption of fortified foods, knowledge of the distance to the nearest health facility and history of babies with congenital disabilities were Predictors of missed antenatal care visits.

However, it is important to note that this study does not explain cause and effect, but rather highlights data that may lead to more robust predictions about a person’s inability to have contact in matters prenatal care. In the future, Dr. Chan and his colleagues hope to validate their models using other study sites and translate these findings into policies and programs aimed at improving access and care.